HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
g 2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
5766 PINETREE DR FT. PIERCE, FL 34982
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I fixrther acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Wdc. SawmLel-
Prop -t ' 0-e11erNa1lie (Please Print)
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ropertq Owner Signature Date
STATE OF FLORIDA, COUNTY OF Ad (n �"J b.—
ACKNOWLEDGED BEFORE ME THIS [:�> DAY OF ""�I 20
BY-Wn D K jo rnffi �:wH0 IS PERSONALLY KNOWN TOME 0) OR WHO HAS
(PR UCED 1� ✓ AS IDENTIFICATION.
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I ffNATUURE\\ F NOTARY PUBLIC TYPE OR PRINT NOTARY
1J�1(J1J'I�COMMISSION NUMBER
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$ • `F': Notary Public • State of Florida
Commission # HH 048045
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SLCPDSD Revised 04/11/2011 .. Bonded through National Notary Assn.